Does a radiology clinical dashboard increase radiologist use of specific reporting language for chest X-rays (CXRs) and thereby decrease rates of unnecessary Emergency Department (ED) prescriptions and follow-up imaging?

Chest X-rays (CXR) are the most common radiologic exam, comprising nearly one third of total KPNC imaging volume. Despite high CXR utilization, diagnostic yield is frequently low, partly due to the paucity of clinical information provided to radiologists at the time of CXR interpretation, resulting in frequent nonspecific CXR assessments which include terms like "opacities" instead of diagnostic terms such as "pulmonary edema" or "pneumonia". This may contribute to over-treatment and unnecessary follow-up CT imaging. This study proposes the production deployment, active promotion, and evaluation of an innovative clinical dashboard called Grasshopper for radiologists to provide pertinent clinical information at the time of CXR interpretation. The dashboard leverages the electronic medical record to programmatically retrieve, and display select clinical notes, patient lab values, and vital signs. The Grasshopper study aims to prospectively evaluate the impact of Grasshopper on CXR report specificity in ED settings across 15 KPNC service areas, and on downstream care process measures such as prescription and imaging utilization.

Kaiser Permanente Northern California CXR is ordered during emergency room visit or inpatient hospitalization

Pending further organizational guidance